Revisiting Katherine Allen’s Tobacco Smoke Enemas in Eighteenth-Century Domestic Medicine

Editor’s note: Today, we revisit a post from 2013 on the myriad and curious uses of tobacco in early modern England.  European imperialism turned the New World domesticate used primarily in ritual into a global commodity of leisure and health.  As Katherine Allen notes in this post, eighteenth century healers also employed tobacco as a remedy for a range of ailments, from rheumatoid pains to the plague.  Tobacco smoke, administered through a pipe called a glister, was used to treat intestinal inflammation and hernias, even in home recipes. This tends to give new meaning to ‘smoke ’em if you got ’em,’ I say.  R.A. Kashanipour


By Katherine Allen

Over the holiday I was working on a transcription of an eighteenth-century recipe book and came across an initially humorous recipe for treating ‘the winde & Collick’ (Wellcome, WMS 3500) which goes as follows:

And so is tobacco given in A pipe [when] it is well Lighted the small end to be oyled and put up into ye fundament and some body put the great end into their Mouth and blow the smoake up into the body this never fails to give ease to the winde collick you may put A small Glister pipe into the body and put the small end of the pipe Tobacco in the End of ye Glister pipe this way will Convey the Smoak into ye body very well. (fol. 87r.)

This surprising description of getting a companion’s assistance in administering the remedy has inspired me to write this post on the history of the familiar phrase ‘to blow smoke up one’s arse [ass]’ and the possible use of tobacco glisters in eighteenth-century domestic medicine.

Tobacco Plant. Image Credit: http://www.spamula.net/blog/i41/non3.jpg

Tobacco (Nicotiana tabacum) is a type of herb in the night shade family Solanaceae. It was smoked by indigenous peoples in the Americas as far back as 1000BC, but gained popularity in Europe and in global markets through trade in the sixteenth century. By the eighteenth century, tobacco was a popular luxury good in England and was increasingly consumed more for pleasure than medicinal treatment.

But how was tobacco used as medicine in the early modern era? Discussing the humoral and astrological qualities of tobacco, Nicholas Culpeper stated in an eighteenth-century version of his herbal that it was a hot and dry herb under the dominion of Mars. Tobacco was useful as an infusion for vomits, rheumatic pain, and piles. As a distilled oil, it was used for aching teeth however, ‘the distilled oil is of a poisonous nature; a drop of it taken inwardly will destroy a cat’. Culpeper also praised tobacco as an expectorant, a digestive aid, and a pesticide for vermin and for preventing plague.[1]

Those who are familiar with recipe collections will have surely come across at least one recipe using tobacco, and the most common recipe seems to have been a tobacco ointment. The Tyrrell Family collection has one such recipe which called for bruised tobacco leaved infused in red wine and then boiled in hog grease along with tobacco juice and beeswax.[2] Tobacco has astringent qualities and acts as a coagulant, and would have been an effective ingredient in salves for treating wounds. Another recipe stated that the tobacco salve ‘is an excellent Mundifier [cleanser] and healer of old sores, and Ulcers, if the sores be first washed with a little good brandy, which ought to be done, till the sores look fresh, which it will do in 3 or 4 dayes if this course be taken.’[3]

Wellcome, WMS 7822, fol. 11r. Image Credit: Wellcome Library

But, when and how did tobacco smoke enemas come into use and how did this treatment come to be in a household book of remedies? The phrase ‘to blow smoke up one’s arse’ means to get a rise or reaction out of someone, sometimes by giving them insincere compliments for attention. This phrase originates from the practice of using smoke enemas to resuscitate near-drowned victims via stimulation and it was first practiced by indigenous groups in North America.[4]

During the eighteenth century, tobacco smoke enemas were used by humane societies across Europe, including the Royal Humane Society in London, to resuscitate victims.[5] Culpeper included the tobacco enema under treatment advice for the inflammation of the intestines induced by colic or hernia and suggested that it ‘is of singular efficacy in obstinate stoppages of the bowels, for destroying those small worms called ascarids [roundworms], and for the recovery of persons apparently drowned.’[6] Physician Richard Mead was a proponent of the tobacco glister, using it to treat iatrogenic drowning caused by immersion therapy for hydrophobia and mania, and later Thomas Sydenham wrote a treatise on its use in bowel obstructions.[7] The use of this treatment declined in the early nineteenth century when it was affirmed that the nicotine found in tobacco can stop blood circulation if there is too much in the body, as in the case of an enema.[8] By the mid-nineteenth century the enemas were not used by the medical faculty.

Tobacco Pipe Enema circa 1773. Image Credit: http://en.wikipedia.org/wiki/File:Tobacco_smoke_enema.png

There is no author associated with the tobacco glister recipe found in MS 3500, but it is likely that this information was communicated to the compiler by a physician. This particular collection is dated 1688-1727 and was owned by a Mrs. Meade (and others), but it does not appear that she was related to Dr. Richard Mead. Several of the recipes are however directly attributed to Dr. Richard Lower for treating the young Nathaniel Meade, one of which is a purge dated the 1st of December, 1688.  There is also one recipe attributed to Dr. Needham on the page before the tobacco glister recipe.

Considering that tobacco enemas were only in vogue from the mid-eighteenth century to the early nineteenth century, it is unusual to find this medical advice in a domestic collection, let alone one dated from the early eighteenth century. As it is improbable that an eighteenth-century household would have had its own tobacco pipe for administering a glister for bowel complaints, I suspect that this recipe is an example of a physician’s remedies being copied into a domestic collection. More importantly, this is an example of how recipe books were continually evolving and being updated alongside innovations in the medical faculty. What started as a chuckle over an amusing recipe has led me to explore the history of this peculiar remedy from its use by the medical faculty to its indigenous origins; giving a whole new meaning for me to the phrase ‘blow smoke up one’s ass’.

 


[1] Nicholas Culpeper, Culpeper’s Family Physician; or Medical Herbal Enlarged. Vol. 2 (London, 1782). p. 134.

[2] Wellcome, WMS 7822. Anon [Tyrrell], ‘Collection of Medical and Cookery Receipts, 17thC-18thC’, fol. 11r.

[3] Wellcome, WMS 1796. Anon, ‘Collection of Cookery and Medical Receipts, c. 1685-c.1725’, fol. 64r.

[4] Raymond Hurt et al., The History of Cardiothoracic Surgery from Early Times (London: Parthenon, 1996). p. 120.

[5] Lawrence Ghislaine, ‘Tools of the Trade, Tobacco Smoke Enemas’ The Lancet vol. 359 issue. 9315 (April 2002): 1442.

[6] Culpeper, p. 281.

[7] Thomas Sydenham, ‘Schedula Monitoria, or an Essay on the Rise of a New Fever’ in Benjamin Rush, The works of Thomas Sydenham, M.D., on acute and chronic diseases: with their histories and modes of cure (Philadelphia: B & T Kite, 1809). p. 383.

[8] Ghislaine, 1442.

Revisiting Diana Luft’s Treating the Stone in Sixteenth-Century Wales

Today we revisit a post originally published in 2017 by Diana Luft on a sixteenth-century recipe against the stone ascribed to a certain Vicar of Gwenddwr, Wales. The recipe is in Welsh, but includes names of some ingredients in English, perhaps indicating an English original. I hope you will enjoy rediscovering this post about a beautiful part of Wales. Laurence Totelin


By Diana Luft

Image of the village of Gwenddwr. Permission granted by the owner of the website Radnorshire Images (John Crellin).
Image of the village of Gwenddwr. Permission granted by the owner of the website Radnorshire Images (John Crellin).

National Library of Wales MS. Peniarth 182 is a miscellany in the hand of Huw Pennant, a poet who lived and worked in Gwynedd and then Carmarthenshire at the turn of the sixteenth century.[1] The manuscript has the look of a personal collection, and it was written over a period of five years, from 1509 until the scribe’s death in 1514. It contains pedigrees, chronicles, religious texts, and texts of a medical nature, including a list of the dangerous days of the year, a short herbal based on Macer Floridus, and two collections of medical recipes. These collections are united by their subject: they all treat the condition tostedd or bladder stone. The first collection has been gleaned from a medieval source; its five recipes can be traced to the four earliest medical manuscripts in Welsh. The second is a mix of recipes that can be traced to fourteenth- and fifteenth-century sources, with the addition of a unique remedy ascribed to an unnamed Vicar of Gwenddwr in Breconshire.

Writing in 1801, Theophilus Jones described the village of Gwenddwr as ‘a vile assortment of huts’, adding that, ‘the best fabric in it is the alehouse’.[2] It may be that the village had fallen on hard times by the nineteenth century, as it seems that its sixteenth-century vicar was recommending a rather complicated, and expensive, course of treatment for bladder stones. Here is the recipe in full:

Rhag y tostedd, medd Bickar Gwenddwr

Kymer ddyrnaid o saets, a’r gymaint arall o’r persli gwraidd ag oll, a’r gymaint arall o’r alisander, a’r gymaint arall o’r ‘selver’ (yr hwn a elwir kynga’r koed), a’r gymaint arall o’r ‘mors off maed lik’ (hynny ydyw, barfav kennin o’r rai ni fflannwyd yn y blaen), a xxxiii o rawn yr eiddaw, a dyrnaid o’r ‘betoni’ (yr rain a elwir kribe sanffred). Golch yn lan hwynt a phwnia mewn mortar kyn vaned a’r grinsaws. Yn ol hyny, bwrw hwynt mewn llestyr glan olchiad, a bwrw arnvn yno dri chwart o hengwrw kadarn, a thri chwart eraill o Rwmnai da. Kymered wraig a dwylaw glan olchiad, a gwasged hwynt hyd pan el ffrwyth y llysiav yn y ddiod. Oddyno kymrud lliain glan a’i hidlo ef yn dda, oddyno bwrw ymaith y soeg, oddyno brew y ddiod hyd pan el chwart o’r chwech chwart dan y brew. Oddyno yskimma ef yn lan, ag oddyno tyn y ddiod oddiar y tan, a bwrw ar y ddiod geinhiagwerth o’r graynys, a dimewerth o’r coleandur,  keinhiagwerth o bowdwr syngir, dimewerth o bowdwr galingall, gwerth tair keinioc o saffrwm, dimewerth o bowdwr licorys. Dod y ddiod ar y tan a gad i verwi ias vechan i gymryd ffrwyth y llysiav. Oddyno tyn i’r llawr, a phan oero ef ddigon, dyro dy ddiod mewn llestyr pridd. Ystopia ef yn dda a lliain glan, a gad yno i sefyll dridiav a theirnos. Yn ol hynny, hidler y ddiod drwy liain glan a rodder i’r glaf y’w yfed yn oer y bore a’r nos, yngwres y gwaed. Arvered o hyn, a iach vydd drwy nerth Duw. Poed gwir Amen

For the stone, says the Vicar of Gwenddwr

Take a handful of sage and the same amount again of parsley, roots and all, and the same amount again of alexanders and the same amount again of ‘cleavers’ (which are called wood burdock), and the same amount again of ‘moss of leek cuttings’ (that is, the beards of leeks which have not been planted before),[1] and thirty-three ivy seeds, and a handful of ‘betony’ (which are called St. Brigid’s combs). Wash them clean and pound them in a mortar as fine as green sauce. After that, put them into a newly-washed vessel and add three quarts of strong old beer, and three more quarts of good Rumney wine. Let a woman with newly-washed hands be brought, and let her press them until the essence of the herbs goes into the liquid. Take a clean linen cloth and strain it well, and throw away the residue, then boil the liquid until one of the six quarts boils away. Skim it clean, remove the liquid from the heat, and add a penny’s-worth of grains of paradise, a halfpenny’s-worth of coriander, a penny’s-worth of ginger powder, a halfpenny’s-worth of galangal powder, three penny’s-worth of saffron, and a halfpenny’s-worth of liquorice powder. Put the liquid on the heat and let it boil for a little while to take the essence of the herbs. Then put it aside, and when it cools enough, put the liquid into an earthenware vessel. Stop it up well with a clean linen cloth and leave it to stand three days and three nights. After that, let the liquid be strained through a clean linen cloth and let it be given to the sick person to drink cold in the morning and at body temperature at night. Let him use this and he will be healed through the strength of God, Amen.

While Pennant’s text is in Welsh, the vicar’s original recipe was likely in English. Most of the ingredients are given in Welsh, but three are in English with Welsh explanations (cleavers, leek grass, and betony). It is not uncommon for Welsh recipes to use English borrowings, especially for foreign or exotic ingredients. The medieval recipe collections contain ingredients such as alym (alum), arment (arnament), atrwm (atrament), brwnston (sulphur), cod (cobbler’s wax), kopros (copperas), and opium. But the English words in this recipe do not refer to foreign or exotic ingredients, rather they indicate the common native herbs. The names of the imported ingredients are borrowings, but they are very old borrowings which have already been incorporated into Welsh. For example, the form coleandur (coriander) appears in Welsh in the earliest herbal glossary, while saffrwm (saffron), licorys (liquorice), and syngir (ginger) are found in the fourteenth-century recipe collections. Thus, while the imported ingredients in this recipe are borrowings, it is the explanations of the common herbs which indicate an English source.

Urine wheel from a fifteenth-century Welsh medical manuscript, NLW 3026 (Mostyn 88), a medical miscellany in the hand of the prolific scribe and poet Gutun Owain. Permission granted by National Library of Wales.
Urine wheel from a fifteenth-century Welsh medical manuscript, NLW 3026 (Mostyn 88), a medical miscellany in the hand of the prolific scribe and poet Gutun Owain. Permission granted by National Library of Wales.

Pennant does not say how he has come by this recipe, whether he has copied it from a book, received it from a friend or neighbour, or perhaps been in correspondence with the vicar himself.  This is the last remedy in this manuscript, all of which treat a common and very painful condition. The collections of remedies in this manuscript, written over a period of years, all treating the same condition, beginning with old remedies taken from manuscripts and ending with what may be the result of correspondence with a contemporary, seems to tell a tale of increasing desperation in the face of an intractable illness. It is impossible to say whether Huw Pennant suffered from bladder stones himself, but the medical texts he chose to include in his collection would seem to suggest that he did. They would also seem to suggest that his interest in these remedies was not academic, but rather practical, that is, that he intended to use them, and may have done so. The cause of Pennant’s death is not recorded. I can only hope that, whatever it was, he received some relief from the ailment that seems to have plagued him for so long.


[1]      This seems to be a reference to the propagation of leeks by removing the seed from the seed head and allowing the head to develop small clones of the parent plant upon it (leek grass), which can then be planted out. I have interpreted mors as representing English ‘moss’, in the sense of a plant resembling moss (OED ‘moss, n.1’ II.4) or perhaps ‘hairiness’ (MED ‘mos’ 1(a)), and maed as representing English ‘math’ that is, a cutting or a mowing, from Anglo-Saxon mæð (OED ‘math, n.1’) and thus mos off maed lik as a cutting of leek, which results in the production of leek grass which is hairy or moss-like in appearance.

[1]      On Huw Pennant see Cartwright, J. 2016. The Middle Welsh Life of St. Ursula and the 11,000 Virgins. In Cartwright, J. ed. The Cult of St. Ursula and the 11,000 Virgins. Cardiff: UWP, pp. 163–86.

[2]      Jones, T. 1809. The History of the County of Brecknock. Vol. 2 of 2. Brecknock: George North, p. 296. You can judge for yourself, from the photograph of the village taken by John Crellin in 2011 for his Radnor Images website (www.radnorimages.co.uk) and used with his kind permission here, whether Jones’s opinion holds true today!

 

Revisiting Erik Heinrichs’ The Live Chicken Treatment for Buboes: Trying a Plague Cure in Medieval and Early Modern Europe

Today we revisit a post originally published in 2017 by Erik Heinrichs on a seemingly odd treatment for plague buboes: the feathers from a chicken’s backside. Erik notes that there is a very long history of using chickens and chicken broths in medicine, partly because chickens are such commonly kept animals. I certainly remember being fed chicken broth when I was ill as a child, but I must say that I broke that tradition with my children. They still get ice cream though… Laurence Totelin


By Erik Heinrichs 

Titlepage of Philippus Culmacher’s plague treatise, Leipzig: circa 1495
Credit: Wellcome Library, London.

While researching German plague treatises I became fascinated by one odd treatment for buboes that appeared again and again, despite sounding so far-fetched. One sixteenth-century version calls for plucking the feathers from around the single hole in a chicken’s backside, then placing it on a person’s bubo. The instructions say to hold the chicken on the bubo until it dies, when it must be replaced with a new chicken, similarly plucked. I soon dubbed this the “live chicken treatment for buboes” and after years of casual encounters I began to track the recipe more systematically. As strange as it sounds, versions of this “live chicken treatment” were fairly common in plague writing, beginning with the Black Death and lasting, amazingly, into the eighteenth century. Tracing the long history of this recipe led me to explore questions such as: Where might this come from? Why chickens? Why might healers think that this was a good idea? Did anyone actually try this or is this all theoretical? As a historian, I was also interested in change over time within the recipe. Here I found much to explore, as I followed the recipe’s twists and turns over a seven-hundred year period, roughly 1000 to 1700.

The “live chicken treatment” turns out to have a long history, indeed. Its origins seem to lie in Avicenna’s Canon of Medicine, although it may be older than that. Chickens and chicken broth were a common source of medicine in early times, probably because chickens were such ubiquitous and useful animals since antiquity. Not only did Avicenna praise chicken broth for its general benefits for the body, but he also recommended placing a cut chicken on a poisonous bite or sting in order to fight poisons. In later centuries European physicians turned to Avicenna’s advice when they faced the mysterious and devastating epidemics of the fourteenth century. As Europeans emphasized the poisonous nature of the plagues around them, older treatments for poisons drew new attention. The first mention of using a chicken rump to draw poisons out of a bubo appeared in the very first plague treatise of 1348, coming in response to the so-called Black Death. Here the Catalan author Jacme d’Agramont seems to have introduced a novel and lasting adaptation of Avicenna’s recipe, although the “cut chicken” version persisted in plague treatises for centuries to come.

Most interesting for the history of trying and testing cures are the many variations of the “cut chicken” and “chicken rump” versions of the treatment, as well as physicians’ comments about how effective they are. Especially after 1400, physicians seem to be thinking about this recipe quite often as they seek practical treatments for the plagues of the time. Physicians were preoccupied with altering the recipe in order to reason out the nature of the mysterious poisons underlying the plague. Some add substances to the process, such as salt placed on top of the chicken as it is placed on the bubo. During the fifteenth century, a number of German physicians began to explain the treatment’s workings in a strikingly physical way—that the chicken breathes through its backside and thus pulls the bubo’s poisons into itself. This change led to the suggestion to hold the chicken’s beak shut during the treatment in order to force the chicken to breathe from below. My article (accessible here) show how all aspects of the treatment changed over time as physicians engaged with the recipe, including the quantity of chickens used, the amount of time required, and even the type of animal in question. This work demonstrates the importance of the recipe itself as a platform for thought, experimentation, and communication among physicians.

Perhaps a surprise to modern readers, many physicians praised their version of the “live chicken treatment,” describing it as effective and desirable. Such comments multiply after the introduction of print, which encouraged the production of plague treatises, some fitted with fetching cover illustrations for the marketplace (see image below of Philippus Culmacher’s treatise of circa 1495). In German-speaking lands especially, sixteenth-century physicians used their printed plague treatises to promote their own services and expertise at a local level.[1] This brought about a change in the genre whereby physicians seem more eager to discuss their own experiences with effective recipes in order to appeal to the practical interests of a broad audience. Amidst this change comes evidence that some German physicians witnessed first-hand the successful use of the “live chicken treatment.” Another interesting change during the sixteenth century is the increased attention to the bodily warmth of the chicken as the treatment’s active healing force. These emergent views provide a tantalizing link to modern medicine, since moist heat remains one of the treatments for buboes today. For more information, please read my article.

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[1] For a survey of German plague treatises from the first century of print, see: Erik A. Heinrichs, Plague, Print, and the Reformation: The German Reform of Healing, 1473-1573 (London: Routledge, 2017).

Revisiting Tillmann Taape’s Recipes against the plague – in pharmaceutical code?

Editor’s note: Today we revisit a post originally published in 2013 by Tillmann Taape on plague remedies given by the apothecary Hieronymus Brunschwig in his Liber pestilentialis (1500). The book included an interesting mix of recipes in the vernacular German and in Latin. Readers unable to read Latin could copy a recipe, visit their apothecary, and collect their anti-plague remedies a little while later. Tillmann’s post offers  insights into the use of Latin as a sort of code. 

It strikes me that, five hundred years on, in the midst of another pandemic, Latin has now been almost entirely replaced by English in scientific discourse. And yet, Latin still lingers on, not the least in the name of the disease that has changed our lives: corona, the crown. To this classicist, the name ‘coronavirus’ calls to mind an evil crown-wearing tyrant. But as it did in the late Middle Ages, Latin obfuscates as much as it clarifies, and I find it fascinating that, to many, the new plague, under its shortened name of COVID-19, evokes not an item of jewellery, but a family of birds: the corvids (Latin: corvidae).

Laurence Totelin


By Tillmann Taape

Although the plague is best known for having wiped out about a third of Europe’s population in the fourteenth century, it continued to loom large as a threat to people’s health for hundreds of years, and medical writings on the Black Death or the ‘pestilence’ abounded. One of them, the Liber pestilentialis (1500) by the surgeon-apothecary Hieronymus Brunschwig (introduced here), was the first of its kind to be published as a printed book. Written in German, it had the potential to instruct a wide readership, reflecting Brunschwig’s mission to disseminate medical knowledge among laypeople. It struck me as somewhat odd, therefore, that quite a few of the recipes for remedies against the plague were given in Latin. What use were these to the readers of a book which was specifically addressed to all social ranks, including ‘common people’ who were not part of the Latin-speaking learned élite? Fortunately, Brunschwig provided an answer only a few pages on: simply copy the recipe on a slip of paper, send it off to your local apothecary, and collect your anti-plague pills a few days later.

Since Brunschwig was himself an apothecary in Strasbourg where the Liber pestilentialis was first published, one might suspect that by including these recipes he was hoping to advertise his trade, and draw attention to the knowledge and skill required to turn such coded messages into remedies. By his own admission, though, this only worked for readers who lived a manageable distance from an apothecary and could afford his services and ingredients, some of which, like theriac or amber, could be very costly. But Brunschwig also catered for those readers who lived in remote villages or were less well off. Often on the same page as the Latin instructions, he included an alternative recipe in German, using cheap everyday ingredients and simple household techniques.

This commitment to his less privileged readers, present in much of Brunschwig’s work, suggests that he was not printing recipes ‘in code’ simply in order to improve apothecaries’ image or to turn a better profit, much less to monopolise medical knowledge. There was, in fact, another very good reason for the use of Latin, as he explains in an intriguing comment: “Many recipes and ingredients cannot be succinctly expressed in the German language […], so I have left them in Latin.”

Some things are best left to professionals: mixing medicines at the apothecary's shop (from Brunschwig's 'Buch der CIrurgia')
Some things are best left to professionals: mixing medicines at the apothecary’s shop (from Brunschwig’s ‘Buch der CIrurgia’). (c) Wellcome Images

This points to a major difficulty faced by all medical authors writing in their native tongue. They were not only up against the disdain of learned physicians who wanted to keep all medical knowledge within university walls, well away from the ignorant ‘common people’. They were also facing the daunting task of creating a scientific vernacular in which to express medical concepts: how the human body works, what happens when it becomes diseased, and what to do about it. Finding their feet on uncharted linguistic territory and creating medical terminologies was the work of generations of practitioners from the middle ages to the early modern era. By the beginning of the sixteenth century, this process had come a long way, as Brunschwig’s writing shows: in his books on surgery and distillation (see here and here), he articulates elaborate techniques and medical theories in a confident technical vernacular – albeit one peppered with terms borrowed from Latin. In the case of specialist pharmaceutical ingredients and preparations, however, Brunschwig clearly felt that no adequate vocabulary was available in German. Some ingredients were just too  specific or too exotic to be known to the layman. Perhaps even more problematic were shorthand instructions such as fiat pulvis (it shall be a powder) or formentur pillule communi quantitatis (pills of equal quantity shall be formed). One can imagine what these few words translated to in practice: complicated series of decoctions, infusions, drying, boiling, grinding and mixing, all defined and learned over the course of an apprenticeship.

With no alternative to certain elements of Latin pharmaceutical jargon, then, the recipes in Brunschwig’s Liber pestilentialis inevitably fell into two categories. On the one hand, his wealthier readers had the option of having ‘professional’ remedies made according to the Latin recipes, which allowed them to tap into the entire range of medicinal ingredients and preparation techniques available at the nearest apothecary’s shop. Poorer folks and country dwellers, on the other hand, were offered a different type of recipe which could be articulated in the vernacular, required cheaper ingredients and could be managed at home.